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Why do I Attend the NASPAG Annual Clinical and Research Meeting (ACRM)? 为什么要参加 NASPAG 临床与研究年会 (ACRM)?
IF 1.8 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-05-06 DOI: 10.1016/j.jpag.2024.04.002
Paula J. Adams Hillard MD (Pronouns: She, her, hers, JPAG Editor-in-Chief)
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引用次数: 0
A Narrative Review of Depression and Suicide in Adolescent Females to Guide Assessment and Treatment Recommendations 青少年女性抑郁和自杀评估与治疗实践指南》。
IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-05-03 DOI: 10.1016/j.jpag.2024.04.003

Study Objective

Suicide is a leading cause of death for adolescents. Medical professionals are increasingly being asked to screen for depressive symptoms and suicidal ideation with little training. The purpose of this paper is to review factors related to suicidal thoughts and actions, assessment of symptoms, and initial suggestions for treatment for medical providers.

Methods

A literature review of risk and resilience factors, assessment measures, and treatment options for depression and suicidal ideation and behavior in adolescent females was conducted.

Results

Given the higher risk of suicidal thoughts and depressive symptoms in adolescent females, accurate and thorough assessment of symptoms is recommended.

Conclusion

Medical providers should be aware of symptoms related to depression and suicidal ideation in order to provide more effective assessments. Recommendations for brief assessment measures that can be used in the clinic and possible first line treatments are provided.

研究目的自杀是青少年的主要死因。越来越多的医务人员被要求筛查抑郁症状和自杀意念,而他们几乎没有接受过这方面的培训。本文旨在回顾与自杀想法和行为相关的因素、症状评估以及对医疗工作者的初步治疗建议:方法:对青少年女性抑郁、自杀意念和行为的风险和复原因素、评估措施和治疗方案进行了文献综述:结果:鉴于青少年女性出现自杀念头和抑郁症状的风险较高,建议对症状进行准确而全面的评估:结论:医疗服务提供者应了解与抑郁和自杀意念相关的症状,以便提供更有效的评估。结论:医疗服务提供者应了解与抑郁症和自杀意念相关的症状,以便提供更有效的评估,并就可在诊所使用的简短评估措施和可能的一线治疗方法提出建议。
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引用次数: 0
Telemedicine for Adolescent and Young Adult Long-Acting Reversible Contraception Post-insertion Visits: Outcomes over 1 Year 青少年和年轻成年人长效可逆避孕药置入后访问的远程医疗:一年的结果。
IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-04-26 DOI: 10.1016/j.jpag.2024.04.004

Study Objective

Telemedicine for long-acting reversible contraception (LARC) care is understudied given the rapid implementation of these services in response to the COVID-19 pandemic. We compared outcomes over 1 year of adolescents and young adults (AYAs) attending a LARC post-insertion visit via telemedicine vs in person.

Design

Longitudinal cohort study.

Setting

Four academic adolescent medicine clinics in the United States.

Participants

AYAs (ages 13-26 years) who received LARC between 4/1/20 and 3/1/21 and attended a post-insertion visit within 12 weeks.

Interventions

none.

Main outcome measures

Outcomes over 1 year were compared between AYAs who completed this visit via telemedicine vs in person. We analyzed the data using descriptive statistics, bivariate analyses, and regression models.

Results

Of 194 AYAs (ages 13.9-25.7 years) attending a post-insertion visit, 40.2% utilized telemedicine. Menstrual management (odds ratio (OR) = 1.02; confidence interval (CI): 0.40-2.60), acne management (P = .28), number of visits attended (relative risk (RR) = 1.08; CI: 0.99-1.19), and LARC removal (P = .95) were similar between groups. AYAs attending via telemedicine were less likely than those attending in person to have STI testing (P = .001). Intrauterine device expulsion or malposition and arm symptoms with implant in situ were rare outcomes in both groups.

Conclusion

Roughly 40% of AYAs attended a post-insertion visit via telemedicine during the first year of the COVID-19 pandemic and had similar 1-year outcomes as those attending in person. The decreased likelihood of STI testing for those using telemedicine highlights the need to provide alternative options, when indicated, such as asynchronous or home testing. Our results support the use of telemedicine for AYA LARC post-insertion care and identify potential gaps in telemedicine care which can help improve clinic protocols.

目的:鉴于为应对 COVID-19 大流行而迅速实施的长效可逆避孕药具 (LARC) 护理远程医疗服务尚未得到充分研究。我们比较了青少年和年轻成人(AYAs)通过远程医疗和亲自参加 LARC 放置后访视一年的结果:我们纳入了在 4/1/20-3/1/21 期间接受 LARC 并在 12 周内接受植入后访视的青少年(13-26 岁)。我们比较了通过远程医疗与亲自完成该检查的青少年在一年内的结果。我们使用描述性统计、双变量分析和回归模型对数据进行了分析:结果:在 194 名接受插管后访视的青少年(13.9-25.7 岁)中,40.2% 的人使用了远程医疗。各组之间的月经管理(OR = 1.02,CI:0.40-2.60)、痤疮管理(p = .28)、就诊次数(RR = 1.08,CI:0.99-1.19)和 LARC 移除(p = .95)相似。通过远程医疗就诊的亚健康人群接受性传播感染检测的可能性低于亲自就诊的人群(p = .001)。宫内节育器脱出或错位以及原位植入的手臂症状在两组中都很少见:结论:在 COVID-19 大流行的第一年,约有 40% 的亚健康人群通过远程医疗接受了植入后就诊,其 1 年后的结果与亲自就诊者相似。使用远程医疗的人接受性传播感染检测的可能性降低,这凸显了在有需要时提供其他选择的必要性,如异步检测或家庭检测:我们的研究结果支持将远程医疗用于青壮年 LARC 插入后的护理,因为一年内 LARC 相关问题的临床结果和医疗利用率与亲自就诊相似。此外,我们的研究结果还发现性传播感染检测是远程医疗护理中的一个潜在空白,这有助于为诊所提供信息并改进其服务方案。
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引用次数: 0
IUD Insertion Under Conscious Sedation: Patient Characteristics with Clinical Decisions 在清醒镇静状态下放置宫内节育器:患者特征与临床决定。
IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-04-18 DOI: 10.1016/j.jpag.2024.04.001

Study Objective

Uptake of intrauterine devices (IUDs) in the adolescent population may be limited by anxiety and pain anticipated during the insertion procedure. Our institution offers conscious sedation for IUD insertion to mitigate this concern. The objective of this study was to identify characteristics and outcomes of teens choosing between two types of conscious sedation for insertion of a levonorgestrel IUD.

Methods

This was a single-site, retrospective cohort study over a one year period, reviewing the electronic medical records of patients who had undergone an attempted IUD insertion using conscious sedation. Conscious sedation included nitrous gas (termed “light” sedation) or intravenous midazolam and fentanyl (termed “moderate” sedation). Patient demographic characteristics and medical and gynecological histories were analyzed.

Results

There were 69 attempted IUD insertions during the study period. Most patients (75.36%) were placed under light sedation, and 92.75% were successfully inserted. The only significant factor associated with choice in the type of conscious sedation was previous sexual activity, which increased the odds by 10.0 that the patient would choose light sedation (95% CI, 1.23-81.34; P = 0.031). Differences between other factors (age, history of sexual assault, tampon use, and gender identity) were not statistically significant between successful and failed insertions.

Conclusion

In conclusion, history of sexual activity significantly differed between patients in our cohort who selected light sedation over moderate sedation. No other factors influenced the choice in sedative or success of IUD insertion. Knowing the characteristics of patients who choose nitrous versus intravenous sedation, and how it relates to successful insertion, may help guide pre-procedural counseling for patients regarding sedation for IUD insertion.

研究目的青少年群体对宫内节育器(IUD)的接受可能会受到置入过程中预期的焦虑和疼痛的限制。我院在放置宫内节育器时提供有意识镇静,以减轻这种担忧。本研究的目的是确定在两种有意识镇静方式中选择左炔诺孕酮宫内节育器置入术的青少年的特征和结果。方法这是一项为期一年的单点回顾性队列研究,研究对象为尝试使用有意识镇静方式置入宫内节育器的患者的电子病历。有意识镇静包括笑气(称为 "轻度 "镇静)或静脉注射咪达唑仑和芬太尼(称为 "中度 "镇静)。对患者的人口统计学特征、病史和妇科史进行了分析。大多数患者(75.36%)都是在轻度镇静的情况下进行的,92.75%的患者都成功植入了宫内节育器。与选择意识镇静类型相关的唯一重要因素是既往的性活动,这使患者选择轻度镇静的几率增加了 10.0(95% CI,1.23-81.34;P = 0.031)。其他因素(年龄、性侵犯史、卫生棉条使用情况和性别认同)之间的差异在成功插入和失败插入之间没有统计学意义。其他因素均不会影响患者对镇静剂的选择或宫内节育器植入的成功率。了解选择笑气镇静与静脉镇静的患者的特征,以及这与成功放置的关系,有助于指导患者在放置宫内节育器时进行术前镇静咨询。
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引用次数: 0
Incorporating Cardiovascular Risk Assessment into Adolescent Reproductive Health and Primary Care Visits 将心血管风险评估纳入青少年生殖健康和初级保健就诊。
IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-04-09 DOI: 10.1016/j.jpag.2024.03.006

Study Objective

This study aimed to evaluate the usability and feasibility of incorporating a cardiovascular risk assessment tool into adolescent reproductive health and primary care visits.

Design, Setting, and Participants

We recruited 60 young women ages 13-21 years to complete the HerHeart web-tool in 2 adolescent clinics in Atlanta, GA.Main Outcome Measures: Participants rated the tool's usability via the Website Analysis and Measurement Inventory (WAMMI, range 0-95) and their perceived 10-year and lifetime risk of cardiovascular disease (CVD) on a visual analog scale (range 0-10). Participants’ perceived risk, blood pressure, and body mass index were measured at baseline and 3 months after enrollment. Health care providers (HCP, n = 5) completed the WAMMI to determine the usability and feasibility of incorporating the HerHeart tool into clinical practice.

Results

Adolescent participants and HCPs rated the tool's usability highly on the WAMMI with a median of 79 (interquartile range [IQR] 65, 84) and 76 (IQR 71, 84). At the baseline visit, participants’ median perceived 10-year risk of a heart attack was 1 (IQR 0, 3), and perceived lifetime risk was 2 (IQR 0, 4). Immediately after engaging with the tool, participants’ median perceived 10-year risk was 2 (IQR 1, 4.3), and perceived lifetime risk was 3 (IQR 1.8, 6). Thirty-one participants chose to set a behavior change goal, and 12 participants returned for follow-up. Clinical metrics were similar at the baseline and follow-up visits.

Conclusion

HerHeart is acceptable to young women and demonstrates potential for changing risk perception and improving health habits to reduce risk of CVD. Future research should focus on improving retention in studies to promote cardiovascular health within reproductive health clinics.

研究目的本研究旨在评估将心血管风险评估工具纳入青少年生殖健康和初级保健就诊的可用性和可行性。我们招募了 60 名 13-21 岁的年轻女性,让她们在佐治亚州亚特兰大市的两家青少年诊所完成 HerHeart 网络工具:参与者通过网站分析和测量量表(WAMMI,范围 0-95)对工具的可用性进行评分,并通过视觉模拟量表(范围 0-10)对其感知的 10 年和终生心血管疾病(CVD)风险进行评分。在基线和注册后 3 个月测量了参与者的感知风险、血压和体重指数。医疗保健提供者(HCP,n = 5)完成了 WAMMI,以确定将 HerHeart 工具纳入临床实践的可用性和可行性。结果青少年参与者和医疗保健提供者在 WAMMI 中对该工具的可用性给予了高度评价,中位数分别为 79(四分位数间距 [IQR] 65,84)和 76(IQR 71,84)。在基线访问中,参与者感知的 10 年心脏病发作风险中位数为 1(IQR 0,3),感知的终生风险中位数为 2(IQR 0,4)。使用该工具后,参与者感知的 10 年风险中位数为 2(IQR 1,4.3),感知的终生风险为 3(IQR 1.8,6)。31 名参与者选择设定行为改变目标,12 名参与者返回进行随访。临床指标在基线和随访时相似。结论年轻女性可以接受 "她的心脏 "项目,该项目具有改变风险认知和改善健康习惯以降低心血管疾病风险的潜力。未来的研究应侧重于提高研究的保留率,以促进生殖健康诊所内的心血管健康。
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引用次数: 0
97. Pain Interference in Adolescents and Adults with Chronic Pelvic Pain Due to Endometriosis 97.因子宫内膜异位症导致慢性盆腔疼痛的青少年和成年人的疼痛干扰问题
IF 1.8 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-04-02 DOI: 10.1016/j.jpag.2024.01.104
Emma Draisin, Catherine Stamoulis, Jenny Gallagher, Sinah Esther Kim, Marc Laufer, Amy DiVasta
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引用次数: 0
1. Adverse Obstetrical Outcomes are Increased in Adolescent Pregnancy 1.少女怀孕会增加不良的产科结果
IF 1.8 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-04-02 DOI: 10.1016/j.jpag.2024.01.143
Anna Scipioni, Holly VanDeman, Jean Paul Tanner, Jason Salemi, Jose Duncan
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引用次数: 0
133. Vulvar Psoriasis in a Young Renal Transplant Recipient 133.一名年轻肾移植受者的外阴银屑病
IF 1.8 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-04-02 DOI: 10.1016/j.jpag.2024.01.140
Joanne Chan, Olga Kciuk, Nichole Tyson
{"title":"133. Vulvar Psoriasis in a Young Renal Transplant Recipient","authors":"Joanne Chan, Olga Kciuk, Nichole Tyson","doi":"10.1016/j.jpag.2024.01.140","DOIUrl":"https://doi.org/10.1016/j.jpag.2024.01.140","url":null,"abstract":"","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"241 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140828521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
101. Pelvic ultrasound in girls with central precocious puberty 101.中枢性性早熟女孩的盆腔超声检查
IF 1.8 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-04-02 DOI: 10.1016/j.jpag.2024.01.108
Liliane Herter, Francine Silva, Francine Bertoncello, Mariane Beust, Noadja França, Cristiane Kopacek
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引用次数: 0
10. Period Poverty Among Adolescent Girls In Miami, Florida 10.佛罗里达州迈阿密少女的经期贫困问题
IF 1.8 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-04-01 DOI: 10.1016/j.jpag.2024.01.155
Emma Marquez , Judith Simms-Cendan , Lisa Gwynn , Renee Morgan , Margia Ambroise , Donna Maturo

Background

Inadequate access to menstrual hygiene supplies, termed “period poverty,” has been documented in low-resource settings globally. However, there is little data on period poverty among American adolescents, with no data available on immigrants or non-English speaking adolescents. The objective of this study is to quantify period poverty among a diverse population of adolescent girls in Miami, Florida. This study determines where adolescents obtain menstrual products, how they cope with inadequate supplies and the effect of period poverty on education.

Methods

Adolescent girls attending public schools served by University of Miami school-based clinics were surveyed upon presentation to the clinic. Students were given menstrual pads with an attached QR code that linked to an anonymous, online survey. Convenience sampling was used. Funding was provided by the NASPAG Young Investigators grant.

Results

73 students completed the survey. 63 surveys were in English, 7 in Spanish and 3 in Haitian-Creole. This is the first study that includes adolescents speaking Spanish and Haitian-Creole. The average age was 15. 60% were born in the United States, 29% in Haiti, 11% in Latin America. 58% of adolescents did not have enough menstrual products available at home in the past year. Every month or almost every month, girls asked family and friends (37%) and/or went to the school clinic (37%). 53% of girls soaked through their clothes with their periods. 41% missed school because of their periods and 14% of girls missed school because of period poverty. Among girls who stated that it was “easy” to manage their periods, 29% missed school because of their periods; among girls who said it was “difficult” to manage their periods, 65% of girls missed school because of their periods. 39% reported getting into trouble at school because of their periods.

Conclusions

Our study represents the most ethnically diverse study population on American adolescents and period poverty available in the literature. The majority of adolescents in our study did not have adequate access to menstrual supplies and school participation was negatively impacted as a result. This study highlights the importance of providing period products in schools and the need that school-based clinics fill by providing menstrual products to vulnerable adolescents. Increasing access to period supplies should be a priority for adolescent health care providers. Health care providers should ask adolescents if they have access to sufficient menstrual products, legislation to provide funding for free menstrual products in schools should be passed, and “banks” of menstrual supplies should be made available in low-resource areas.

背景在全球资源匮乏的环境中,经期卫生用品供应不足被称为 "经期贫困"。然而,有关美国青少年经期贫困的数据很少,也没有关于移民或不讲英语的青少年的数据。本研究的目的是量化佛罗里达州迈阿密不同少女群体中的经期贫困现象。本研究确定了青少年从哪里获得月经用品、她们如何应对用品不足的问题以及经期贫困对教育的影响。方法在迈阿密大学校本诊所服务的公立学校就读的少女在前往诊所时接受调查。学生们获得了附有二维码的月经垫,二维码可链接到匿名在线调查。调查采用便利抽样法。结果73名学生完成了调查。63 份调查问卷使用英语,7 份使用西班牙语,3 份使用海地克里奥尔语。这是第一项包括讲西班牙语和海地克里奥尔语的青少年的研究。平均年龄为 15 岁。60% 出生于美国,29% 出生于海地,11% 出生于拉丁美洲。在过去一年中,58% 的青少年家中没有足够的月经用品。每个月或几乎每个月,女孩们都会询问家人和朋友(37%)和/或去学校诊所(37%)。53% 的女孩在月经期间衣服湿透。41% 的女孩因月经而缺课,14% 的女孩因月经贫困而缺课。在表示 "容易 "控制月经的女孩中,有 29% 因月经而旷课;在表示 "难以 "控制月经的女孩中,有 65% 因月经而旷课。39% 的女孩表示因为月经而在学校惹上了麻烦。在我们的研究中,大多数青少年无法获得足够的经期用品,因此对学校的参与产生了负面影响。这项研究强调了在学校提供月经用品的重要性,以及校本诊所通过向弱势青少年提供月经用品来满足其需求的重要性。青少年医疗服务提供者应优先考虑增加经期用品的供应。医疗服务提供者应询问青少年是否能获得足够的月经用品,应通过立法为学校免费提供月经用品提供资金,并在资源匮乏的地区建立月经用品 "银行"。
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引用次数: 0
期刊
Journal of pediatric and adolescent gynecology
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